Targeting Populations for Routine HCV Screening

Current guidelines recommend routine HCV screening among the baby boomers, the birth cohort 1945-1964. The high HCV prevalence in this population makes routine screening cost-effectiveness, while similar screening in other populations is not. There are additional populations with high prevalence and/or incidence of HCV, but they remain limited in screening coverage and overlooked by current screening guidelines.

Youth under the age of 30 have a rising incidence of HCV infection related to expanding prevalence of injection drug use, but providers often fail to obtain an accurate risk assessment. The population of individuals born in endemic countries but now residing in the US is also at a higher risk for HCV, and should be screened routinely.

This project will explore the impact and cost-effectiveness of expanding HCV screening recommendations to include the population at large, risk-targeted populations, and settings of differing HCV prevalence.

Our major research questions include:

What are the clinical outcomes, comparative costs and cost effectiveness of strategies to expand routine HCV screening beyond the “birth cohort” to include screening in those ages 15-35, as well as those born in HCV endemic countries who immigrate to the U.S.?

What is the threshold of HCV prevalence and/or incidence above which routine screening becomes cost-effective?